Title:ASGE Predictors for the Diagnosis of Choledocholithiasis: Validation in a
Public Hospital of Merida, Yucatan, México
Volume: 3
Author(s): Richard Camilo Aguirre-Sanchez, Abraham Hernan-Herrera-Sanchez, Carlos Enrique Perez-Osorio and Maria Fidelia Cardenas-Marrufo*
Affiliation:
- Clinical and Epidemiological Research Unit, School of Medicine, Autonomous University of Yucatan, Merida, Mexico
Keywords:
ASGE predictors, choledocholithiasis, calculus, ultrasound, bile duct, choledochotomy.
Abstract:
Background: Choledocholithiasis is defined as the presence of calculus in the biliary
tract, and is one of the main complications of cholelithiasis. Its prevalence among the Mexican population
is 14%.
Objective: To determine the validity of predictors of choledocholithiasis in patients attending the
Hospital Agustin O’Horan from January 2019 to December 2020.
Methods: This was an observational, analytical, and retrospective study. It included patients with a
diagnosis of choledocholithiasis, and it evaluated the sensitivity, specificity, as well as positive and
negative predictive values for risk criteria of the American Society for Gastrointestinal Endoscopy
(ASGE).
Results: Ninety-six medical histories were analyzed. Ninety were from women and six from males
(94% and 6% respectively), and the average age was 40 years. The registry shows an increase of
serum ALP, AST, and ALT in 98% of the reports, and elevated levels of bilirubin in 19% by 1.3-4
mg/dl, and 76% by >4 mg/dl of them. Moreover, the records showed pancreatitis and cholangitis
(8% each one). The ultrasound reports indicates that 96% of the patients had a choledochal cyst
higher than 5 mm, while 54% had a choledochal litho. Sensitivity and specificity of ASGE criteria
for the diagnosis of choledocholithiasis was 96.6% and 45.5% respectively, and a Positive Predictive
Value of 16% and a Negative Predictive Value of 99%.
Conclusion: It is considered that the diagnostic accuracy test of the ASGE criteria for the diagnosis
of choledocholithiasis is high.
